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Published on: May 11, 2016
Cancer stem cell biomarkers SOX2 and Oct4 in cervical cancer patients undergoing chemoradiotherapy
Deep Chakrabarti1,2, Sumaira Qayoom3, Kirti Srivastava1
1Department of Radiotherapy, King George's Medical University, Lucknow, India.
Background:
Cancer stem cell biomarkers SRY (sex-determining region Y)-box 2 (SOX2) and octamer-binding transcription factor 4 (Oct4) account for radioresistance in cervical squamous cell cancers (CSCCs). Their clinical implications are limited and contradictory.
Methods:
In this prospective cohort study, we recruited patients with FIGO IB2-IVA CSCC treated with primary chemoradiotherapy on regular follow-up. Tissue biopsy specimens were evaluated for SOX2 and Oct4 expression by immunohistochemistry, quantified by a product of proportion and intensity scores.
Results:
A total of 59 patients were included. Most had a moderately differentiated (81%), keratinizing (59%) CSCC, and ≥FIGO stage IIB disease (95%). SOX2 expression (high:low 21:38 patients) and Oct4 expression (high:low 4:55 patients) had a significant interrelation (p = 0.005, odds ratio (95% CI) - 1.23 (1.004-1.520)). At a median follow-up of 36 months, the 3-year overall survival (OS) was 60% and 53% for low and high SOX2 expression (p = 0.856), and 54% and 100% for low and high Oct4 expression (p = 0.114). The 3-year disease-frese survival (DFS) was 65% and 50% in the low and high SOX2 expression (p = 0.259), and 59% and 75% for low and high Oct4 expression (p = 0.598). SOX2 expression was the only variable significantly associated with a lower OS and DFS on regression analysis.
Conclusion:
Our study demonstrated a trend toward improved OS and DFS with low SOX2 and high Oct4 expression in CSCC patients undergoing chemoradiotherapy.
Insights
Low SOX2 and high Oct4 expression may improve outcomes for cervical squamous cell cancer (CSCC) patients treated with chemoradiotherapy. Further research is needed to confirm the clinical significance of these cancer stem cell biomarkers.
Area of Science:
- Oncology
- Cancer Stem Cell Biology
- Biomarker Research
Background:
- Cancer stem cell biomarkers SRY (sex-determining region Y)-box 2 (SOX2) and octamer-binding transcription factor 4 (Oct4) are implicated in radioresistance in cervical squamous cell cancers (CSCCs).
- The clinical implications of SOX2 and Oct4 in CSCC remain unclear due to limited and contradictory evidence.
Purpose of the Study:
- To investigate the prognostic value of SOX2 and Oct4 expression in patients with CSCC undergoing chemoradiotherapy.
- To determine the association between SOX2 and Oct4 levels and clinical outcomes, including overall survival (OS) and disease-free survival (DFS).
Main Methods:
- A prospective cohort study involving 59 patients with FIGO IB2-IVA CSCC treated with primary chemoradiotherapy.
- Immunohistochemistry was used to evaluate SOX2 and Oct4 expression in tumor biopsy specimens, quantified by a product of proportion and intensity score.
- Statistical analysis, including regression analysis, was performed to assess the association between biomarker expression and patient outcomes.
Main Results:
- SOX2 and Oct4 expression showed a significant interrelation (p=0.005).
- At 3-year follow-up, low SOX2 expression was associated with a trend toward improved OS and DFS, while high Oct4 expression showed a trend toward improved OS.
- Regression analysis identified SOX2 expression as the only variable significantly associated with lower OS and DFS.
Conclusions:
- Low SOX2 and high Oct4 expression demonstrated a trend toward improved overall survival and disease-free survival in CSCC patients receiving chemoradiotherapy.
- These findings suggest a potential prognostic role for SOX2 and Oct4 in CSCC, warranting further investigation.
